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Dermatology (IHD Den303) > Skin > Flashcards

Skin Flashcards

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Dermatology Board Prep flashcards
1
Q

Dermatology

A 
Lumps and bumps
Psoriasis and eczema
Oral manifestations
Important infections (!)
Skin tumours
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2
Q

Erysipelas

A

Acute infection typically with a skin rash, usually on any of the legs and toes, face, arms, and fingers
Infection of upper dermis and superficial lymphatics
Usually caused by beta-hemolytic group A Streptococcus bacteria on scratches or otherwise infected areas

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3
Q

Examinations

A

Examination and description of lumps
Neck examination
Common skin lumps
Skin cancers

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4
Q

Most common skin conditions

A

Psoriasis, exzema, contact dermatitis

  • differential may be difficult
  • red patches, swelling, itchy, painful
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5
Q

Psoriasis vs eczema

A 
Psoriasis
-well defined
-red with scaly surface
-adults
-unknown cause
-trunk, limbs, knees
-scalp and nails
-psoriatic arthritis
Eczema
-poorly defined
-red without scales
-children
-allergens, 
-face, hands
-NOT scalp and nails
-no arthritis
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6
Q

Koebner phenomenon

A

Wheels appear after scraping skin

-appearance of skin lesions on lines of trauma

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7
Q

Contact dermatitis

A

Type of inflammation of the skin resulting from irritants or allergens
-only superficial layers of skin affected

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8
Q

Psoriatic arthritis

A

typically causes affected joints to become inflamed (swollen), stiff and painful
-long term condition that can get progressively worse

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9
Q

Aetiology of psoriasis

A

HLA association
T-cell mediated
Keratinocyte proliferation early

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10
Q

Aetiology of eczema

A 
No HLA association
Uncertain cause IgE
-skin barrier permeable
-atopic eczema: Type 1
-allergic contact dermatitis: Type 4
Hyperkeratosis late
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11
Q

Treatment of psoriasis

A 
Reduce keratinocyte proliferation
-vit D
-coal Tar
-dithranol
-retinoids
Immune suppression
-steroids
-methotrexate
-biologicals: TNF blocker
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12
Q

HLA/ MHC

HLAB27

A

On surface of our cells to tell us that these are our own cells
-cell-surface proteins responsible for regulation of the immune system in humans
The presence of HLA-B27 is associated with certain autoimmune and immune-mediated diseases, including ankylosing spondylitis, reactive arthritis, and sometimes lesions on your skin

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13
Q

If it’s wet dry it, if it’s dry wet it, if in doubt stick some steroids on

A

Wet, oozing lesions should be dried, dry lesions should be hydrated and lubricated

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14
Q

Treatment of eczema

A 
Identify triggers 
Emollient cream
Topical steroids
Antihistamine for itch
Antibiotics if infected
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15
Q

Oral manifestations of skin disease

A

Lichen planus
Herpes infections
Blistering conditions

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16
Q

Lichen planus

A 
Itchy, papular rash
Flexor surfaces, mouth and genitalia
Haven't found antibody to it yet
-develop destruction of own tissues (not severe)
-chronic inflammatory infiltrate
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17
Q

Lichen planus typical histological appearance

A

Band-like T cell infiltrate
Saw-shaped rete ridges
Acanthosis (thickening) of basement membrane

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18
Q

Herpes infections

A

Chickenpox
Herpes zoster (shingles)
Herpes simplex virus
Recurrent herpes labialis

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19
Q

Associations of herpes

A

Whitlow

Ocular keratitis

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20
Q

Whitlow

A

Herpetic whitlow is a lesion (whitlow) on a finger or thumb caused by the herpes simplex virus
Painful infection that typically affects the fingers or thumbs

21
Q

Post herpetic neuralgia

A

Nerve pain which occurs due to damage to a peripheral nerve caused by the reactivation of the varicella zoster virus

22
Q

Examination of lumps

A 
Site
Size
Shape
Mobile or fixed
Consistency
Surface
Covering skin/ mucosa
Pulsatile etc.
23
Q

Site of lumps

A

Neck

Face, scalp, nose

24
Q

Size, shape

A

Two dimensions unless it is round

If round: fruit (pea/ grape), then golf ball size

25
Q

Mobile or fixed

A

Can it be moved freely
Fixed to skin/ bone/ muscle
-probably cancerous

26
Q

Consistency

Surface texture

A

Hard, firm, soft, rubbery, fluctuant

Irregular, smooth, craggy

27
Q

Covering skin/ mucosa

A

Normal, ulcerated, colour, erythema, blanches

28
Q

Other features

A

Compressible
Pulsatile
Thrill
Bruit

29
Q

Common skin lumps and pigmented lesions

A 
Epidermal cyst
Basal cell carcinoma
Squamous cell carcinoma
Vascular malformations
Seborrheic warts
Benign pigmented naevi
Melanoma
30
Q

Gorlin’s

A

Gorlin syndrome, also known as nevoid basal cell carcinoma syndrome, is a condition that affects many areas of the body and increases the risk of developing various cancerous and noncancerous tumors
*** listen to recording

31
Q

Seborrheic warts

A 
More in elderly
Basal cell papilloma
May be multiple
Well defined
Raised edge
"Warty" pigmented
32
Q

Epidermal cysts

A 
AKA sebaceous cyst
Fixed to skin
Punctum
History of discharge
May become infected
33
Q

Removal of a sebaceous (epidermal) cyst)

A
  1. Cross section
  2. Injection of LA
  3. Elliptical incision with scalpel
  4. Removal of cyst
  5. Final suture line
34
Q

Basal cell carcinoma

A

Common in elderly
Scalp, face and neck (80%)
Light exposure, genetic predisposition (Gorlin Goltz)
Variable appearance

35
Q

BCC edge

A

Shiny bit round the outside

‘Pearlescent’ edge

36
Q

Basal cell carcinoma appearance

A 
Well defined
Rarely (never) metastasises
Slow growing
Pearly edge
May crust, then appear to regress
37
Q

Pigmented naevi

A

Mole
Blue, compound, junctional, intramucosal
Can get in mouth

38
Q

Non-melanoma skin cancer

A 
BCC
-elderly
-sun exposure
-face and head
-slow growing
-does not metastasis
SCC
-elderly
-sun exposure
-face, head and arms
-variable growth
-may metastasise
39
Q

Melanoma

A
  • younger patients
  • sun exposure
  • trunk and limbs
  • variable growth
  • metastasise often
40
Q

Keratoacanthoma

A

skin lesion that erupts in sun damaged skin, rather like a little volcano
Grows for a few months, then may shrink and resolve by itself
Considered to be a variant of the keratinocytic or non-melanoma skin cancer, squamous cell carcinoma (SCC)

41
Q

Malignant melanoma

A

LOOK AT DIAGRAM
Type of cancer that develops from the pigment-containing cells known as melanocytes
Typically occur in the skin, but may rarely occur in the mouth, intestines, or eye

42
Q

Malignant melanoma - what to look for

A

Asymmetry
Border irregularity
Color
Diameter: 1/4 inch or 6mm?

43
Q

Treatment of BCC

A

Surgery
-4mm margin
Radiotherapy
Imiquimod (immune stimulation)

44
Q

Treatment of SCC

A 
Surgery 
-1cm margin (a lot)
-primary
-lymph node metastasis
Radiotherapy
45
Q

Treatment of melanoma

A 
Surgery 
-1-3cm margin (a lot)
-primary
-lymph node metastasis
Radiotherapy
46
Q

Lichen planus vs lichenoid reaction

A

Reaction is where there is something adjacent causing it e.g. amalgam

47
Q

Angioedema

A

Area of swelling of the lower layer of skin and tissue just under the skin or mucous membranes
Swelling may occur in face, tongue, larynx, abdomen, or arms and legs
Often associated with hives, which are swellings within upper skin

48
Q

Impetigo

A

bacterial infection of the surface of the skin
Usually Staph aureus
-in hot climates may be strep pyogenes

Dermatology (IHD Den303) (2 decks)

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